<script type="text/javascript" src="/templates/scripts/checkinput.js"></script>
<table width="98%" border="0" align="center" cellpadding="0" cellspacing="0">
    <tbody>
        <tr>
            <td class="bgtitle">
                <table border="0" cellpadding="0" cellspacing="0" bgcolor="#FFFFFF">
                    <tbody>
                        <tr>
                            <td width="20">
                                <img src="/templates/images/mui_ten.gif">
                            </td>
                            <td valign="bottom" class="title">Đăng ký thành viên</td>
                            <td width="10" valign="bottom">&nbsp;</td>
                        </tr>
                    </tbody>
                </table>
            </td>
        </tr>
        <tr>
            <td valign="top">
                <img src="../images/space.gif" width="1" height="10">
            </td>
        </tr>
        <tr>
            <td valign="top">
                <table width="100%" border="0" cellspacing="0" cellpadding="5">
                    <tbody>
                        <tr>
                            <td style="border:1px #CCCCCC solid; padding:10px">
                              
                                <form action="/register" method="post" enctype="multipart/form-data" name="registerForm" id="registerForm" style="margin:0; padding:0" onsubmit="return verifyregisterForm(this)">
                                    <table width="55%" border="0" align="center" cellpadding="3" cellspacing="0" bordercolor="#CCCCCC" style="font-family: Tahoma; font-size: 10pt; border-collapse:collapse; padding:10px">
                                        <tbody>
                                            <tr>
                                                <td width="35%">Địa chỉ email (*) </td>
                                                <td width="70%">
                                                    <input name="email" type="text" class="box_input" id="email" size="24">
                                                </td>
                                            </tr>
                                            <tr>
                                                <td>Mật khẩu (*) </td>
                                                <td>
                                                    <input name="pass" type="password" class="box_input" id="pass" size="24">
                                                </td>
                                            </tr>
                                            <tr>
                                                <td>Nhập lại mật khẩu (*) </td>
                                                <td>
                                                    <input name="pass2" type="password" class="box_input" id="pass2" size="24">
                                                </td>
                                            </tr>
                                            <tr bgcolor="">
                                                <td valign="top">Họ và Tên (*)</td>
                                                <td>
                                                    <input name="fullname" type="text" class="box_input" id="fullname" size="24">
                                                </td>
                                            </tr>
                                             <tr bgcolor="">
                                                <td valign="top">CMND (*)</td>
                                                <td>
                                                    <input name="cmnd" type="text" class="box_input" id="cmnd" size="24">
                                                </td>
                                            </tr>
                                             <tr bgcolor="">
                                                <td valign="top">Địa chỉ (*)</td>
                                                <td>
                                                    <input name="address" type="text" class="box_input" id="address" size="24">
                                                </td>
                                            </tr>
                                            <tr bgcolor="">
                                                <td valign="top">Điện thoại</td>
                                                <td>
                                                    <input name="phone" type="text" class="box_input" id="phone" size="24">
                                                </td>
                                            </tr>
                                            <tr bgcolor="">
                                                <td valign="top">Mã bảo vệ (*)</td>
                                                <td>
                                                    <table border="0" cellspacing="0" cellpadding="0">
                                                        <tbody>
                                                            <tr>
                                                                <td width="50">
                                                                    <input name="codeprotect" type="text" id="codeprotect" class="box_input">
                                                                </td>
                                                                <td width="10">&nbsp;</td>
                                                                <td class="title16">{$captcha}                       
                                                                    <input type="hidden" name="codeprotect2" id="codeprotect2" value="{$captcha}"></td>
                                                            </tr>
                                                        </tbody>
                                                    </table>
                                                </td>
                                            </tr>
                                            <tr bgcolor="">
                                                <td valign="top">&nbsp;</td>
                                                <td><table border="0" cellspacing="0" cellpadding="0">
                                                        <tbody>
                                                            <tr>
                                                                <td>
                                                                    <input type="submit" name="button" id="button" value="Đăng ký">
                                                                </td>
                                                                <td width="10">&nbsp;</td>
                                                                <td>&nbsp;</td>
                                                            </tr>
                                                        </tbody>
                                                    </table>
                                                </td>
                                            </tr>
                                            <tr bgcolor="">
                                                <td valign="top">&nbsp;</td>
                                                <td style="padding-top:10px;">Vui lòng điền đầy đủ, chính xác các thông tin trên, để chúng tôi có thể cung cấp dịch vụ tốt nhất cho bạn</td>
                                            </tr>
                                        </tbody>
                                    </table>
                                </form>
                            </td>
                        </tr>
                    </tbody>
                </table>
            </td>
        </tr>
    </tbody>
</table>